Growth Plate Fractures and Injuries (cont.)
What Kind of Doctor Treats Growth Plate Injuries?
For all but the simplest injuries, the doctor may recommend that the injury
be treated by an orthopaedic surgeon (a doctor who specializes in bone and joint
problems in children and adults). Some problems may require the services of a
pediatric orthopaedic surgeon, who specializes in injuries and musculoskeletal
disorders in children.
How Are Growth Plate Injuries Treated?
As indicated in the previous section, treatment depends on the type of
fracture. Treatment, which should be started as soon as possible after injury,
generally involves a mix of the following:
Immobilization
The affected limb is often put in a cast or splint, and the child is told to
limit any activity that puts pressure on the injured area.
Manipulation or Surgery
If the fracture is displaced, the doctor will have to put the bones or joints
back in their correct positions, either by using his or her hands (called
manipulation) or by performing surgery (open reduction and internal fixation).
After the procedure, the bone will be set in place so it can heal without
moving. This is usually done with a cast that encloses the injured growth plate
and the joints on both sides of it. The cast is left in place until the injury
heals, which can take anywhere from a few weeks to two or more months for
serious injuries. The need for manipulation or surgery depends on the location
and extent of the injury, its effect on nearby nerves and blood vessels, and the
child's age.
Strengthening and Range-of-Motion Exercises
These treatments may also be recommended after the fracture is healed.
Long-Term Followup
Long-term followup is usually necessary to monitor the child's recuperation
and growth. Evaluation includes x rays of matching limbs at 3- to 6-month
intervals for at least 2 years. Some fractures require periodic evaluations
until the child's bones have finished growing. Sometimes a growth arrest line
may appear as a marker of the injury. Continued bone growth away from that line
may mean that there will not be a long-term problem, and the doctor may decide
to stop following the patient.
Next: What Is the Prognosis for Growth in the Involved Limb of a Child With a
Growth Plate Injury? »
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